The role of biochemical markers in predicting worsening heart failure; comparison of biomarkers / Kötüleşen kalp yetmezliğini öngörmede biyokimyasal belirteçlerin rolü; biyobelirteçlerin karşılaştırılması

Objective: Heart failure is the end stage of many cardiac disorders. Worsening heart failure causes high mortality in these patients. In the present study, we aimed to elucidate and compare the biochemical predictors of worsening heart failure. Methods: One hundred one patients with heart failure were included in this study. Patients were divided into two groups according to their functional status. N-terminal pro-brain natriuretic peptide (NT-pro BNP), troponin T, serum and urine creatinine, blood urine nitrogen (BUN), eGFR, cystatin C, neutrophil gelatinase associated lipocalin (NGAL), C - reactive protein, hepatic transaminases and thyroid stimulating hormone levels were measured. Results: NT-pro BNP, troponin T, serum creatinine, BUN, cystatin C and NGAL levels were significantly higher but urine creatinine level and eGFR was lower in decompensated heart failure patients. In univariate analysis, age, cystatin C, NGAL, NT-pro BNP and serum creatinine and eGFR predicted worsening heart failure (WHF). In multivariate analysis, cystatin C and NT-pro BNP variables were found to be significant in predicting WHF. However, eGFR were determined at the limit of significance (p=0.053) with an high odds ratio 3.173 (95% CI:0.983-10.240). Cystatin C and NT-pro BNP concentrations were predictors of worsening heart failure. In ROC analysis, cystatin C is a better predictor of decompensated heart failure compared with NT-pro BNP and other predictors, and has a sensitivity of 82% and a specificity of 63%. Conclusion: This study revealed that cystatin C and NT-pro BNP were significant predictors of WHF, and cystatin C is slightly better predictor of WHF. Further studies are needed to confirm these results.